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General NPI Number Information
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NPI Number | 1235367459
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Entity Type | Organization
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Legal Business Name | TEMPLE PHYSICIANS INC
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST 3RD FL ROCK PAVILION
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-926-9022
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Fax | 215-226-8286
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Provider Business Mailing Address
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Address Line | PO BOX 820933
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0933
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Country | US
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Telephone | 215-926-9010
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Fax | 215-226-8285
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ERIC MANKIN
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Credential | MD
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Telephone | 215-926-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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